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Millard Fillmore
13th president (1850-1853)
Background/Early Life
• Millard Fillmore was born in upstate New York, and his family struggled to make ends meet. After a failed apprenticeship with a clothmaker, Fillmore worked to put himself through school, studied law and became a lawyer.
• Fillmore entered the political world by serving as a New York state lawmaker, then won election to the United States House of Representatives.
• Fillmore was chairman of the Ways and Means Committee in his final term as a Congressman, then lost an election for governor of New York after leaving the House. He was elected a few years later as New York's comptroller. This win put him in position to be named Zachary Taylor's running mate in 1848. Taylor won the election, but Fillmore did not play a major role in any decision-making in the White House.
• When Taylor died suddenly in 1850, Fillmore became president of the United States.
How he defined the office
• Fillmore didn't believe in slavery on principle, but he believed that in order for the country to resolve its disputes on the issue, compromise was necessary.
Successes and failures
• The Compromise of 1850 was passed early in Fillmore's time as president. It settled some of the slavery issues of the day but for each compromise that made one part of the country happy, someone else was left upset.
• Fillmore, to please Southerners threatening to secede, strongly enforced the Fugitive Slave Law, which stated that runaway slaves needed to be returned to their owners. This, in turn, upset abolitionists.
• Commodore Matthew Perry made his trade mission to Japan during Fillmore's presidency. While the mission was not completed until after Fillmore left office, it resulted in Japan opening up for trade with the rest of the world.
• Fillmore was not very popular by the end of his time in office. He had little interest in running again, nor did the American people want him to.
notable quote
• "God knows that I detest slavery, but it is an existing evil, for which we are not responsible, and we must endure it, till we can get rid of it without destroying the last hope of free government in the world."


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Photo Booth Hire Horncastle
This area includes the LN9 5 postcode, Lincolnshire, East Lindsey District.
This area includes the LN9 5 postcode, Lincolnshire, East Lindsey District.
Say Hello on the Boothco Party Photo-booth. This may be the hottest in photo-booth technology and the ideal addition for your own event.
Desire great group photos of you and all of your guests? The Boothco Party photo-booth may be the perfect solution for you personally. Studio-quality photos, brightly colored prints and fantastic props. High in customisable features which can fully entertain everybody in your occasion.
We cover the whole of Horncastle and surrounding areas.
All events have various styles also to appeal to the we now provide a large range of designer backdrops. Our inhouse picture designer may use you to re create your printing design. This typically contains a method which fits your event, your name and the event day.
Our number one aim would be to catch fantastic memories and also for all to appreciate the photobooth experience.
Horncastle photo booth hire packages will add that extra bit of fun to your next event.
If you have any questions about hiring our photobooths in Horncastle you can contact us here.
View the Boothco Party photobooth differs from several different providers!
Hello and welcome to Boothco, We have a wide selection of photo booths please select your prefered style.
Our all-new selfie drop off pod was a favourite 2020 and perfect for all types of event. This self-service selfie pod includes unlimited prints, photo album and is our most cost effective photo booth solution.
Our amazing multipurpose selfie pod can be fully styled to suit your event. With its beautiful elegant design and high quality prints, it's the perfect pod for any occasion!
Magic Mirror photo booth has our largest interactive screen and stands out at any event. Instant print and amazing lighting are the key features of our magic mirror.
Our classic party booth is an all round hit at any event. The enclosed space of the booth is always a popular choice for capturing those special party moments.
The all-new Virtual Photo Booth. Take branded photos and GIF's from any device from anywhere in the world. No-App download required and perfect for every type of event.
Create the perfect GIF to instantly share on social media. Creat that social media buzz at your next event with this awesome GIF pod. Create a photo, GIF or video using our cool digital props.
Branded selfie pod hire for all types of event from award shows to product launches. From branded front and back to full wraps, our eye catching pods always look awesome!
Green screen, otherwise known as immersive photography, transports your guests into a new world, scene or experience. Our fully customisable green screen software and hardware builds a fully immersive experience.
We'll arrive in your own venue one hour or so before to install all of the apparatus and conduct several test shots to make sure the photo and light is ideal. As we're ready to begin we'll allow you to realize to make sure that you're satisfied with the comprehensive installation then it's time and energy for you to shoot your selfie and then make the fun begin!
Unlike other Horncastle photobooth businesses we now design and fabricate of our stalls inhouse and we usually do not rely upon any three rd party service or applications and that means that you can assure that you're hiring out of the photo-booth pros . Our team are fully trained, and we bring backup gear to each occasion.
Our bash photobooth hire contains a fully personalised printing design. Our inhouse graphic designer will make a customized print for the own event. This design has a tendency to add your own name, event day and also will be themed to accommodate the occasion. Usually we provide 4 by 6″ prints or dual strip prints although other choices can be found. These photos are then immediately published after your photo a backup uploaded into your secure online photogallery.
Contrary to other Horncastle photobooth hire businesses, this agency is completely contained in our Party Booth bundles and only reason that you need to reserve Boothco for another event.
We offer a photobooth guestbook at every event for a keepsake for the clients to get hold of and relish.
Every photo is published and the record is filled throughout your own event. Guest may create a personalized message near your own photo. You are going to get the photoalbum at the close of the evening time.
When it's perhaps not shared on societal networking it's never happened! Our bash photo-booth creates magnificent GIFs with the ideal light to be shared across societal networking. Create magnificent boomerang GIF's with pals, funny props and props that are virtual.
Once you've established the GIF you are able to put in your telephone or email information and we'll immediately send you a hyperlink to down load your GIF.
Log in to your societal networking marketing and then upload the GIF showing everybody else just how much fun you are having at the occasion.
Wonderful props is really a necessity with hire. Everybody likes to dress to get a mad photo and we've got an ideal range of fun clocks on the own event.
By the traditional fake moustache to mad full horse thoughts masks we'll offer the pleasure for the event! We're testing digital props to get an electronic virtual covid safe secure experience.
We'll arrive at your Horncastle venue an hour or so prior to your event and create fast and gently from the field we all have on your own. It is going to roughly take us 3-5 about 45 minutes to finish the installation. We'll have several test shots to make sure the camera and light is perfect after which open at the specified period.
We normally conduct the photo-booth for 34 hours that's dependant upon the hire package that you choose. We now staff the party stall through the hire. Helping your guests utilize the photo booth and solving any problems the apparatus could have. Throughout the hire, we'll add a duplicate of each photo in to the scrapbook and invite your guests to compose a message.
Once that the hire has ended, we'll turn off each of the apparatus and get rid of the apparatus. Your event might take full swing but don't worry we could get rid of equipment readily and free of significant difficulties. As we've removed the gear we provide you the finalised photoalbum with photos and individual messages. We'll even send you a URL to all of your photos 4-8 hours following your event. You're able to talk about this internet gallery together with guests.
Photo, Photo and more photos! Every single time you see the party photobooth we'll immediately provide you two prints each session. Wish your guests to continue employing the photobooth throughout your event, no issues! We'll never go out of paper or ink in your own event and all of your guests can be able to utilize the photobooth through the hire period.
A standard event we publish between 250 to 300 photos a hour hire semester. Additionally you will obtain a copy or most of these photos in the photo record. We utilize the hottest in photobooth printing technology and only utilize Mitsubishi dye sublimation printers.
By investing at the very best printing technology we now can offer top quality, nearly-instant and completely signature dry prints. Need to compare with our photo caliber? Drop us an email together along with your speech and we ship a complimentary sample of this photo for you personally in this article.
Its essential that the prints you get at the finish of your event are top quality since these would be the memories of one's event!
Not merely do we believe the photobooth needs to be fun nevertheless also the caliber of photo output has that wow element. What sets apart besides additional photo-booth businesses is the high quality of equipment that we utilize.
We developed our photobooth technology whereby that lets us examine and refine each of different light solutions and camera-lens to make sure the right photo every moment.
The present variant of the party photo-booth utilizes the newest Canon M-50 mirror-less camera and also a studio-grade Elinchrom Display system. This creates a totally balanced photo.
At the finish of your event, we'll upload all of your photos to the online gallery that is secure. It is possible to talk about this gallery together with guests and those who can not create your event. It is possible to down load most of the high time pictures directly out of the particular gallery.
We'll continue to keep this gallery on the internet for at least 2 decades free from charge. This gallery is totally discretionary of and also we will not upload some photos of kids and also we can get rid of any photo immediately when asked.
Covid 1 9 lock-down was terrible for everybody however throughout the worse of this and we're excited about this 2021 and 2022 year old. Our policy is truly simple if your event becomes transferred because of covid 1 9 can we do our utmost to support your date. When we cant adapt your date that's most unlikely we'll give you the complete refund. If your event becomes cancelled thanks to covid 1-9 we'll refund 100 percent of your deposit or balance which you've previously paid.
We have been as you are if events become transferred or cancelled thus that we find it just fair work together to locate all probable solutions. If you would like to explore this further please provide us a telephone number.
Our equipment is regularly tested and independently PAT assessed to make sure all of the safety in any respect times. Additionally, this means that every site lets us make use of their power supplier. With this normal testing, we've known wedding places to deny using power onsite throughout the marriage. We may even run a generator off if required however we will need to get informed before your own event.
We now endure to 5million of people liability insurance policy . We have not had to make use of it some other insurance its give us and you that a reassurance. When anybody did get hurt with our photo stalls you understand we'll soon be insured for any damages upto number 5 million.
Ordinarily, send the insurance and also PAT certification to the place directly but in the event that you take a copy please contact us.
Our awesome photo-booth operators would be the key to getting a fantastic event. Our staff have extensive training and above all amazing with people. We ardently feel that exceptionally motivated team with the proper training is crucial to the results of just about any corporation.
Throughout your event, the photobooth operator will arrive at an hour or so before the start time and energy to establish and can operate the stall throughout the entire lease period. Helping guests, ensuring that the high quality of the photos and amusing your guests will be in a night's work with professional operators.
In case you have some questions regarding how we put up and conduct your event, please call us to talk.
Everybody loves a photograph filter. Most our stalls are given a vast range of fantastic insta style filters.
These generally include colour, black & white, sepia and also an assortment of insta inspired colours that are classic. After the photo session, then the user may preview and choose which one photo-booth filter effect touse.
We've got a choice of various party stall fashions to accommodate almost every occasion. From into VW camper and snowy heart, we now have all of it!
If you're seeking an entirely bespoke layout, simply tell us and we are able to adapt this at an extra price.
Your event is going to be special and often a once in a lifetime occasion. We understand this which is why you should trust Boothco with your event.
We will go above and behind to help you organise your perfect photo booth experience. Help you decide on the backdrop style, personalised photo design and plan the day's timings with yourself. During the event, we will ensure everything runs smoothly and without a hitch. Interacting with your guests and ensuring everyone has an awesome photo booth experience.
We treat every event as a once in a lifetime experience and we have the equipment, staff and know-how to capture your special moments.
Samantha Doughty
Co-founder of Boothco Ltd
Your event is going to be special and often a once in a lifetime occasion. We understand this which is why you should trust Boothco with your event.
We will go above and behind to help you organise your perfect photo booth experience. Help you decide on the backdrop style, personalised photo design and plan the day's timings with yourself. During the event, we will ensure everything runs smoothly and without a hitch. Interacting with your guests and ensuring everyone has an awesome photo booth experience.
We treat every event as a once in a lifetime experience and we have the equipment, staff and know-how to capture your special moments.
Samantha Doughty
Co-founder of Boothco Ltd
Our photo booths are great for capturing memories and also add fun to any occasion in Lincolnshire. If you are trying to employ a photo booth for a wedding, corporate or birthday party close to Horncastle then please submit a request a quote.
I reserved the photo booth for the wedding reception as a surprise to my guests, so it was idolised by all and some friends wouldn't leave the stall all night. The entire method of booking had been so plain sailing along with the group was super helpful. I will be recommending to all my family and friends for sure.
If you're seeking to hire a photo booth in Horncastle we have many different stalls to suit any celebration. We've got party stalls, selfie pods, magic mirrors and selfie postboxes. We personalise the minute prints and you will get two copies, one for the guest to take home and one for your photo message book where we influence your party goers to give you a hand written message. At the end of every event we deliver you the digital copies for one to prize.
Moreover, if you're interested in a exciting way to get your business noticed in Horncastle then our photo booths are ideal. With instant printing and societal networking sharing your customers will depart with a branded photograph with your emblem. We cover Horncastle and all places in Lincolnshire.
Let Boothco provide you with the best photo booth for your wedding or party in Horncastle.
We love to chat about your next event and we have found that a quick Zoom chat is the easiest way to discuss all your requirements. Click on the button below and schedule a time and date that suits you.
If you prefer to discuss via email you can use the contact form below or the email us at [email protected] .
Your event details
We will contact you via email to discuss your event.


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Rule #1 - Be Patient - Rule #2 - Don't ask when, if you don't contribute - Rule #3 - You have coding skills - LinuxMCE's small brother is available: http://www.agocontrol.com
I have to take offence to your comment "I will not let anyone else implement it". I always thought the philosophy of the project was "he who writes the code, writes the rules", so if someone else implements this, are you saying you will block its submission? This may be a minor issue in itself, but if that is, in fact, what you are saying it represents a very serious shift in the project philosophy. That would deserve, I would respectfully suggest, an open discussion of its own.


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PaceSetter Header 70-2374
- Our Price: $409.09
- Shipping:FREE SHIPPING
- Part Number: 70-2374
- Rating: (41)
- Availability: Out of Stock
Long Tube Headers
- Part #: 70-2374
- 1-7/8 In. Tubing Diameter
- 3 In. Collector Diameter
- Not Carb Exempt
- Not legal for sale or use in all 50 states
- Black Painted
$409.09Free Shipping
Select your vehicle details above to ensure item compatibility.
- Race-worthy performance and sweet sound come at an affordable price when you go with a PaceSetter Header
- 16-gauge mild steel tube is mandrel-bent for excellent flow
- Choose from standard Black paint or exclusive heat-resistant Armor*Coat finish
- Easy, bolt-on installation for most models (welding required for some models)
- Includes positions for factory sensors
- Header bolts not included
- Made in the USA
- 3-Year Warranty
Face it - your restrictive stock headers are robbing you of power. If you've been lacking punch under the pedal, it's time to bolt up some quality PaceSetter Headers. PaceSetter has been consistently putting out quality, high-performance exhaust components for over 30 years, and their experience shows. Their Headers harness power, lower temperatures, and even improve your under-the-hood looks.
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PaceSetter 70-2374 fits:
- 2005-2013 Chevrolet Corvette
There are no reviews for this application.
See All PaceSetter Header Reviews.


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|20.00 lbs
|28.00 × 40.00 in
Shell Design Shop is part of Shell Lumber and Hardware of Miami, FL. Founded in 1928, we have over 92 years of exceptional retail service reputation. We have access to many of the top design industry brands with competitive prices. Please feel free contact us or call us so our professional experts can help you find what you need.


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The Macro Plus GPS is the perfect device for casual to serious cyclists that just need the main essentials of a cycling GPS computer. New features include an optional horizontal orientation, an improved water resistant plug, and enhanced styling. Its hardware and firmware have also been improved with a higher resolution screen and the ability to connect with our "Smart Connect" LED system. In addition to its full GPS recording capabilities, it fully ties in with our GPS platform when paired with our GPS Ally phone app. When paired, the device offers full turn-by-turn navigation, phone notifications, Lezyne Track (live tracking), Strava Live Segments, training integration and device customization. Additionally, the Macro Plus GPS can pair with external Bluetooth sensors. And it offers up to 28-hours of battery runtime.
- Navigate with Komoot
- Create interactive videos of your ride with Relive
- Lezyne Track: Subscription-free live tracking and telemetry
- Durable, composite construction
- Optimized GPS satellite recording
- Bluetooth Smart connectivity
- Multiple real-time features when paired to the Lezyne Ally app
- Simple setup through Lezyne Ally phone app
- Import .tcx and gpx. Files
- Trainer Mode
- Multiple bike profiles
- Full navigation
- Custom route building
- Intuitive four button operation
- Lithium polymer battery provides up to 28 hours of runtime
- Micro USB rechargeable
- Stores up to 100 hours of ride data
- Customizable fields and page count (up to 8 fields)
- Custom alerts and auto presets
- Extremely weather resistant
- Includes X-Lock Standard Mount
- Smart Connect compatible
- Receive text, email, phone call and message app notifications when paired to smartphone
- Sync rides via Bluetooth Smart to the Lezyne Ally phone app
- Instant download of ride files (.fit) via plug-and-play flash drive technology (Windows/Mac) - and upload directly to GPS Root website for ride analysis
- Auto-sync to Strava, TrainingPeaks and Today's Plan
- Pairs with Bluetooth Smart enabled heart rate monitors, cadence/speed sensors and power meters
- Turn-by-turn navigation
- Off-line rerouting
- Follow starred Strava segments and routes
- Follow structured workouts from Today's Plan and TrainingPeaks
Display Data
- Turn-by-turn navigation
- Live Tracking icon
- Strava Live Segments
- Structured Workout
- Heart Rate: Current, Average, Max.
- Cadence: Current, Average
- Power (6 data display options)
- Training Specific Fields: TSS, NP, IF
- Speed: Current, Average, Max.
- Distance: Current, Trip Total, Trip 2, Odometer
- Time: Ride Time, Clock
- Date
- Laps and lap averages
- Elevation: Ascent, Descent, Current
- Calories
- Temperature
- GPS signal strength
- Battery life indicator for device and paired devices
- Connected devices icons
- Bread crumb trail page
- GPS Computer
- Heart Rate Flow Sensor
- Pro Sensor
- Cadence Speed Flow Sensor
- Alloy Forward Mount
- Micro USB Charging Cable
- Mount for bar/stem with 2 large O-Rings, 2 small O-Rings
- WEIGHT: 60g
- RUNTIME: 28 hours
- MEMORY: 100 hours max
- DIMENSIONS: Computer 70.6mm (W) x 48.16mm (L) x 26.0mm (H); Screen: 32.6mm (W) x 39.8mm (L)
Part Numbers


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UP 25/7.5 PCV – Downloads
Filter/SortFileCategoryFiletypeRelease date
User manuals in other languages can also be found on the respective country websites or simply be ordered from us.
Installation Information:
Please ask your local power supply utility or a registered electrician to install appliances that are not fully wired, i.e. ready to plug in. The electrician should also be able to assist you with obtaining the agreement of the respective power supply utility required for the appliance installation.


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Tuesday, August 16, 2011
Ob/Gyns are terrible people who need to die, and other common misconceptions
I'm not really certain if I fall into the category of one of the "pleasant" Ob/Gyns or not, but I will give this question a shot. Bitterness and Ob/Gyn, alas, does seem to go hand-in-hand. I believe that, first and foremost, it is an incredibly important, busy, special, and stressful job. True, most of our patients are healthy, but when they get sick, they can get sick quickly, and when healthy young women or babies get sick, injured, or die on our watch? That's especially devastating. I can't think of a single person that went into Ob/Gyn as a bitter person who hated women, but at the end 4 years of constant sleep deprivation, sometimes another pregnant woman in labor is no longer a miracle, it just means more time spent away from fulfilling basic human needs like using the bathroom, or eating, or, most elusive of all, sleep! It is also seeing women, not only at their best but at their very worst, hours of staring at monitor strips, worrying about when to pull the trigger on a cesarean delivery, wondering, if it is too early that we will be blamed for "unnecessary surgery" and trying to get to our golf game or (God forbid) home for dinner, or, if too late, we will, much worse, have a sick or damaged baby (and possibly be sued for everything we have). Women can be very difficult patients, who require a lot of communication, not a problem for patients who are willing to return to discuss issues, more of a problem for people who wish to stuff a year's worth of problems into a 10 minute annual exam. It's persistent 36 hour shifts, often skipping breakfast and/or lunch, and 72 hour weekends (remember how much you hate call Fizzy? Would you be bitter if you did it all the time?) It's adrenaline burn-out, hours of nothing followed by a harrowing roller coaster. It's constantly being second-guessed, by our partners, other physicians, the L&D nurses, the patients, the internet, the media, ourselves, even when we *know* we are practicing to the *standard of care* for our profession.
It's the malpractice, multi-million dollar coverage premiums to pay yearly, the threat of lawsuits for up to 18 years after the fact, shrinking reimbursement (universal for all physicians), trying to pay our staff and our overhead, having to fit more patients into the same hours in the day, trying to be a good doctor for them, trying to at least support our family since we can seldom be there to see them. It's medicine, surgery, primary care, and caring for two patients all rolled into one, and sometimes it eats at your humanity. Sometimes, you come home at the end of the day so emotionally exhausted that you have little to give to the rest of your family. Sometimes the sadness of discussing a cancer diagnosis, or miscarriage, or fetal death lasts for weeks or days. Sometimes it is impossible to *not* take your work home with you. Sometimes we care *too* much, causing us to start separating ourselves from our patients, building a wall, becoming callous, so the better to protect ourselves.
Sometimes we deal with the stress in inappropriate ways: too much wine, snarky humor, or snappish answers. Likely, many of us are clinically depressed. Many of us have little time to exercise (Rh+ and her most excellent example notwithstanding). Because women Ob/Gyns are women too, and usually mothers and wives, who feel guilty when we are at work and guilty when we are at home, just like other working mothers. Because, despite how much it sucks, we still really love our jobs, think pregnancy and birth is amazing, and wouldn't do anything else (even if we wish we could); because we care about mothers, women, and babies. Hope this answers the question in a non-bitchy way, please excuse the sentence fragments and horrendous grammar. I had a terrible, horrible, no-good, very bad day today, and seeing some of the commentary on Mothers in Medicine regarding my profession, usually a refuge, stung quite a bit, I must say.
***cross-posted at Ob/Gyn Kenobi
47 comments:
Admittedly, I had some problems with my ob/gyn rotation in med school, but I did have some thoughts on how to keep my residents happy:ReplyDelete
Seriously, though :) Aside from the one story I related in my last post, my experience as a *patient* with female ob/gyns has been very positive. The one I have now (even though she made a recommendation that I might not agree with and the wait for appointments is maddening) is the sweetest woman ever. And I respect ob/gyns more than any other specialty, because you guys have a really hard and noble job. I get so angry when people supporting homebirth start talking smack about how obstetricians are so evil.
But yeah, I really felt abused by the residents during my ob/gyn rotation in med school. I've never been treated so cruelly on a rotation. There were residents I worked with on other rotations who were clearly miserable, but nobody got mistreated like the med students on ob/gyn. To the point where the clerkship director had to gather all the residents and tell them they were going to be in big trouble if they continued treating us that way.
That's the part I don't get: the inconsistency between the wonderful ob/gyns I've had as a patient vs. the horrible experience all med students seem to have.
Beautiful post. I always appreciate reading posts from doctors that defend their profession and explain some of the stresses associated with it. Coming home after my own terrible, horrible, no-good, very bad day, it's good to hear that I'm not alone in the medical world.ReplyDelete
I have never commented on this blog, but wanted to give my two cents on this topic, and on the metamorphosis so many of us take when we enter into residencies.ReplyDelete
My perspective is that of a former Ob/gyn resident. I decided after my first year of Ob/Gyn residency that I wanted to change careers, and am now happily an anesthesia resident after finishing 2 years of a grueling Ob residency where I had a total of about 5 weekends off over my residency span. I was a part of a wonderful program with excellent training, but was so miserable it wasn't until I finally had my head above the water that I could look back and see just how far I had sunk.
I think part of the problem with Ob/gyn physicians lies in the training. It is miserable. Laboring patients these days seem to fall into a few categories in residency training programs:
1) Women who are normal, healthy, realistic about labor and deliver a normal, happy, healthy baby: ~30%
2) Women who come in with the dreaded "birth plan", doula, birthing ball, what have you and with the misconception that all obs are out to cut/offer them pain medicine/perform unnecessary interventions: ~15%
3) Women who are very unhealthy, diabetic, morbidly obese, grandmultiparous and at risk for a million and one complications: ~30%
4) Women who are healthy and everything goes to crap in a second (intrauterine fetal death, fetal acidosis resulting in long term complications, extremely preterm labor, etc): ~15%
5) Women who come into labor high on meth/crack/marijuana: ~10%
Each one of those scenarios, with the exception of 1, is mentally and physically draining. Being up all night with all of those scenarios happening all at once, multiple nights a month for most months out of 4 years, is absolutely exhausting. I watched so many residents fade into shadows of their former selves during my few years there, and now that I am on the other side of the curtain, I see it continuing to happen. It seems like even when residency is done, some of them still have that "bitchy" side that only came out once they were ingrained into the residency program.
I agree with a previous commenter that litigation is also a problem. Lack of adequate surgical training and volume also makes the gynecologic part more stressful then it should be. Gynecologic oncology can be rewarding, but also so sad as many of the patients are relatively young. Ob/gyns are expected to be primary caregivers (routine health maintenance, pap smears, mammograms, etc), surgeons, and obstetricians and are just expected to wear too many hats. I struggled endlessly with the fact that for my own child, I wanted to my obstetrician to be there for the delivery because I really liked her and I knew her. So how could I expect my patients to not want the same thing? How could I chose between delivering a well-known patient's baby or attending my daughter's swim meet when both events are so important in each of their lives? I don't know how Ob/gyns do it without an endless amount of guilt on both ends, and thus I would think bitterness would be inevitable.
That all being said, I had such wonderful people where I trained that I know there are so many great MDs out there who are perfect for the field. I don't know how they do it, but I respect them immensely. When I left, the majority of people I talked to said they wouldn't do anything else, despite being a little bitter about things. I hope everyone has an Ob/gyn in their lives that they can trust and turn to, as I think the field is so important in so many ways.
Fizzy~ I had a good Ob experience as a student (very big, busy L&D), but our residents were so busy (read, no coddling, no teaching, no hand-holding) they needed every hand they could get. We did all of the "normal" deliveries with the midwives (CNMs), the residents were in the OR most of the day. When we did deliver with the residents, they totally left us on our own to suture lacerations/episiotomies, et.cetera. Sink or swim! Scut was the name of the game when I was a student, it didn't really phase me, I never felt that it was malignant. When I was a resident (smaller program with more "private" type patients), I think it could be frustrating for students, because our patients often wouldn't want a resident touching them, much less a student, so they didn't always get to do much at delivery. No fun! We did try to teach, and we would ask them to go get food on call (when nothing was going on), but we bought their dinner if they did it, none of us could go off campus, and the hospital food sucked!ReplyDelete
Solitary Diner ~ Thank you. It is always good to know we are not alone out here. :)
Marce ~ A-freaking-men. Yes, exactly. Glad you have found a field that is a better fit for you.ReplyDelete
- AnonymousAugust 16, 2011 at 10:37 PM
Marce --ReplyDelete
Out of sincere interest, what does being "realistic" about labor mean to ob residents? I really wanted a baby to come out of my vagina, but it did not. Things felt pushy. I'm assuming I was being unrealistic, but I felt like there was an under-appreciation for the fact that this was a really big deal for me.
Dr. Whoo -ReplyDelete
My dad is a neonatologist. My ex, who was in med school at the time, wanted to do OB - loved the thrill of labor. Dad encouraged him not too, based on watching the careers of his classmates and the OB's he worked with. The devastating, often unfair lawsuits that destroy their love and ability to do OB. The burnout. My ex went into anesthesia. My dad defends OB's in the courtroom - has for years.
I too had bad experience, like Fizzy, with female OB residents as a med student, with the exception of one. I felt like I was the unpopular girl in high school again. My OB is female - had her for 9 years. She is the most calm, even, wonderful person. I consider her a friend, but I am a little starstruck by her whenever I see her, even though I am a colleague. We laugh, she listens, and she calms my fears and answers my questions intelligently and thoughtfully. I have referred non-medical field friends to her and she treats them the same way - they worship her as well. Although I can tell she is not the kind of person who would treat doctors better, it is reinforcing to get this feedback from my peers.
You are a superhero. I was way too chicken to do what you do.
Hope your day tomorrow is much much better.ReplyDelete
Dr. Whoo,ReplyDelete
I don't even know you, but I gotta say, you're my new hero. You have put into words every single thing I think about when I picture what it will be like to be an Ob. And for that, I am grateful. All women that dislike Ob's should read this post.
- AnonymousAugust 16, 2011 at 11:23 PM
I took my first call since delivering my first-born 12-week-old last night, so this post really hit home. I love my job. I never thought I wanted to be an OB/Gyn (who dreams about that growing up?!), but after my first few months of medical school, I wasn't interested in anything else. Damn me. I also practice in an amazing community and have even more amazing partners. And despite having a reflux-y baby at home, I actually slept last night. But whenever I'm on call, which is weekly, I have reminders about why we are a bitter group.ReplyDelete
For me, it has little to do with the economics of it. I know I could work less and earn more in some other specialties, but I honestly don't care. I know my malpractice premiums are ridiculous, but that alone isn't enough to make me upset.
What upsets me is the way we are treated by others, both our patients and our colleagues. Last night is a prime example.
Around 1830, I fielded a call from one of my regular patients wanting to know if her birth control was causing the anxiety attacks she had been having for over 2 weeks. So many things wrong with this conversation, the primary one being that as a "primary care" doctor, my life is being interrupted after-hours by a problem that has been going on for 2 weeks. I suppose I could have declined to take the call, but that surely would have had affected my reputation in the lay community. And I'm sure I'm not the only reader of this blog who has fielded calls at 0200 on a Sunday from a patient who very sweetly apologizes for calling so late and then asks how to use her over-the-counter yeast infection cream because she lost the instructions (and you say that it's no big deal since you're still up anyway).
Of course, I was sitting at the hospital twiddling my thumbs when that call came in because OB is one of the few specialties that hospitals deem so dangerous that nurses can't administer medications we prescribe routinely. Specifically, if a patient requires prostaglandins for labor induction at my hospital, I have to place the first dose myself. Of course, labor induction is not an urgent procedure, so the pharmacy sees no need to get me the medication my patient needs. As a result, I sat on L&D for 2 hours waiting for the pharmacy to get its act together, in the meantime, missing my opportunity to see my baby before he headed to his grandparents' house for the rest of his waking hours. Chemotherapy can be administered by the nurses without a physician present, but Cervidil cannot. The oncologists can order routine, toxic medications remotely; I cannot order a medication that is essentially an analogue of a chemical that is naturally produced by the human body. Our institutions apparently think our decision-making is too haphazard to support, and our families suffer as a result.
However, what is worst, as far as I'm concerned, is the lack of respect we get from other physicians. This morning around 0500, I was hung up on by a female emergency department physician. I agreed come in right away to see the patient she thought might have an ectopic. I don't know if my comment that I didn't think it was an ectopic annoyed her--what I meant was that she didn't need to call the OR team in--but I nearly broke down in tears on my way in. I realize it's my job to see those patients, but not saying "goodbye" or "thanks" is the ultimate disrespect. Wrapping up the conversation is the least you can do when you're waking up someone who is likely sleep-deprived to begin with and doesn't get to go home after an 8-hour shift. These moments make me feel like people see me as a puppet, as if the ED doc was qualified to determine that the patient required surgery and that was I was just there to do the deed.
And, no, it was not an ectopic.
And she didn't have to have surgery. But perhaps in standing my ground, I got called some unpleasant names. Just another night on call....
- MelissaAugust 16, 2011 at 11:34 PM
Very nice post. In med school I had a decent experience on my OB/GYN rotation. I liked learning the material but didn't like the actual clinical practice. I am not a fan of performing surgery and do not like to be in the OR. The residents I worked with were very nice although I heard horror stories about some of the residents that I didn't work with. I got lucky in that department.ReplyDelete
I've always had female OB/GYNs. I've never had a problem and I love my current doctor. I do have to wait up to an hour sometimes but I always try to give her the benefit of the doubt. I know she is working hard and OBs can't really predict when a patient will be delivering. I really came to appreciate this when I gave birth at 4:50pm on a weekday after two hours of pushing...and my OB was there the whole time. Back at her office the patients were piling up I'm sure.
Both Dr. Whoo and Marce have done done a great job of explaining the crazy, strange world of OB/GYN.ReplyDelete
I have to make a daily decision to not let myself become bitter. I try to focus on the positives;on the things that I do that allow me to truly make a difference.
As hard as I try not to practice defensive medicine or focus on lawsuits, there are constant reminders in our newspapers and journals of multimillion dollar verdicts. I saw one today, where an OB misread an US and a baby was born with down syndrome. The OB was liable for $3 million dollars.
I thought my senior residents were mean and bitchy when I was an intern. When I was a chief, I realized, that while a few of the things were unnecessary that they did; most things that at the time seemed awful, were just them attempting to get all the massive amount of work done in their own bitter sleep deprived state.
It is hard to leave your favorite patient in labor, miss your sons first day of school or look into a hopeful patients eyes and tell them that their is no heartbeat. These things do not get easier with time, but you learn to cope with them without guilt.
At the end of the day I love my job. I consider it a privilege to be involved with each of my patients birth. The minute it becomes just a 'job' that's when its time to hang up the stirrups.
What? You mean you didn't work endless hours giving up time with your family and denying yourself things that everyone else would consider routine (like going to the bathroom), just for the opportunity to torture women and put babies in danger?ReplyDelete
I know some people (in all specialties) don't deal with stress in the most productive way. And some people (in all specialties) are just jerks. But my experience in med school and as a patient, is that Ob/gyne is like any other specialty where the physicians are working to the best of their ability in the interests of their patients.
A beautifully written piece. Thank you OB-Gyne Kenobi for explaining again why doctors are as human as everyone else. My husband is in Critical Care and your post could just as easily explained his mood as any OBs.ReplyDelete
Never had a female OB/GYN or any other doctor - not for any particular reason, just kind of worked out that way. But it seems like the male OB/GYNs carry similar cynicism... which I still (truthfully, even after reading all of the above do not understand). I work as a nurse in the PICU and with many critical care attendings, fellows and I just don't see them talking to our parents the same way my OB talks to me. Yet, somehow, I think their hours on call in house and with patients could match in intensity of work and time commitment to that of an OB resident (I dare say). Clients are different: not ALL women, but sick children and their parents, but who said that's easier?ReplyDelete
I have learned quite a bit working in the PICU when it comes to personal communication methods and trying to understand other people's reasons for being demanding, rude to nursing and medical personell, and granted I don't know what patients think of me, but I can definitely echo the sentence about "building a wall" of sorts to "better protect ourselves" because I have found it works best for me, not only for my own internal psyche, but also in being politically correct, straight and non-emotional with my patients. Although I sure hope I don't sound like that to my patients. :( But alas, I probably do. And then we'll go around in full circle and some parent or med student is going to write a blog about "that bitchy" nurse who was callous to me.
Oh and Dr. Whoo (sorry for writing all of the above and actually NOT writing what I meant... my labetalol is fogging my head!), thank you for the post. I actually do like my OB (who is male, as I've mentioned), he is an awesome physician, I'm just trying to figure out his quirky personality, but it sounds like it has to be quirky in order to tolerate the screaming, demanding and unreasonable women (at times) in order to function as a normal human being. In my nursing school rotations, L&D started as my goal and ended with my least favorite. Sorry, couldn't work with the patients you work. My hat goes off to you. Big time.ReplyDelete
- mom of two and docAugust 17, 2011 at 6:55 AM
I'm sorry you had a bad day (love that book). I had a good experience on ob/gyn as a med student, almost went into it but then realized that while I loved delivering babies, i really liked the complicated medical issues (call me crazy) more than surgery and preventive gyn care. Residents were generous about letting me help with stuff, the attendings were admirable and supportive.ReplyDelete
I just want to say that i am eternally grateful to my ob practice - saved the life of my first born who was totally unexpectedly in major distress when he was born, and they were attentive and responsive and caring the whole time he was in the NICU. They have gone on to be attentive, supportive, great listeners through 3 subsequent pregnancies, one ending in miscarriage, one still cooking. yes, there have been things that have not been perfect, but i would never have expected perfection, and i think things are harder for ob/gyn(more call, liability, etc. etc.). so, although I'm certain I've not been your pateint or med student, i just want to say thank you. it makes me sad that you had to even write this post.
The residents on my ObGyn rotation were split. The good residents were some of the best I had on any rotation. The bad residents made me want to walk into oncoming traffic. The bad ones were the mean girls from high school. Like Gizabeth said, they made me feel like I was the unpopular girl in junior high. The only way you could win on that rotation was a) to be a hot guy, b) be completely silent (though I suppose they'd have accused me of trying to sneak away if I'd done that), c) know everything already. None of those were options for me.ReplyDelete
Unfortunately, this impression I got from my ObGyn rotation has followed me as I have see ObGyns since then. Mostly I've had good experiences as a patient, but every time I see one, but I'm still terrified that they're like the jerks I worked for on my rotation.
I find it interesting that Dr. Whoo says that it's the patients that make ObGyns miserable. My observation was that the residents made each other miserable. Not once did I see a resident cry because of something a patient did or said. By contrast, I often saw residents cry because of being berated by their residents.
Great post! I am impressed with your thoughtful response despite having had a rotten day and I imagine that you exercise that ability (to respond eloquently while irritable) frequently. Regardless, I appreciated what you had to say and admire you for all that you do.ReplyDelete
- Kellie (General Surgeon)August 17, 2011 at 9:20 AM
Surgical type residencies are difficult and grueling and OB/GYN fits right into that.ReplyDelete
I HATED my OB rotation. My father got extremely ill during my rotation (which I disliked even before this) and when I called my resident, they were kind but said I had to call the director. He basically told me that "oh,sure, your dad is sick". When I called to tell him I'd be gone a little longer because my dad had passed away, he was again quite callous. I told him I'd "bring the f'ing death certificate and I'd expect an apology" he never said another word. I was of course worried I'd get in trouble, but I suppose he was afraid my side would come out.
I've had nothing but good experiences wtih my OB/GYN's as a patient, thank goodness.
I'm sorry that you had such a bad day, dr. whoo... and then you had to read some of the commentary. I have days where I read commentary about physicians in general and get so upset. Sad that a few can taint the entire profession, be it OB/GYN, medicine, surgery.. whatever. Hope today is better.
Dr. Whoo: I was just reading your post again in the light of day and I wanted to say that I apologize if you took anything I said as a jab at your profession. I definitely didn't mean it that way. I won't take back what I said about that one specific doctor who happened to be an ob/gyn because I really disliked her, but as you know, there are doctors in every field who are bad at communicating.ReplyDelete
My experiences as a patient these days mainly involve ob/gyns, so obviously those are the docs I'm going to talk about. But like I said in my first comment, I have the utmost respect for the specialty, and I was constantly defending ob/gyns in the pregnancy communities I joined. I'm really sorry if anything I said came off as an attack on you or ob/gyn. I think you guys are heroes.
- AnonymousAugust 17, 2011 at 12:40 PM
While I do honestly believe that some medical specialists get paid more than they're worth, I would never say that about OB/GYN. You guys deserve every penny and you have my admiration. --full-time pediatricianReplyDelete
Dear Dr. Whoo - I applied for the match in OB and surgery however decided after applications were sent that I definitely wanted to do surgery. However, that said, I was one of the those medical students who enjoyed my OB rotation, and my med school was one where even as students we had lots of autonomy and worked really hard. I ultimately decided not to do OB for some of the reasons you listed after talking with some people I trusted and because it started to become clear that I really loved surgery.ReplyDelete
However, as a shout out to you, I will say that my experience with my recent pregnancy was phenomenal. The OB's at my practice were amazing - I looked forward to going to my appointments. They watched out for me as a surgery resident and were ready to fight for me if need be to make sure I had a healthy pregnancy (I had a bedrest threat pretty early on). They encouraged me as a surgical resident. I truly felt that we were partners. Ironically, the only person in the practice I didn't like was one of the two males. I am very grateful to these wonderful doctors who took care of me and my baby. I know you hear lots of bad stuff about OB's, so I hope this can counteract it, if only a little!
I hope today you have a good, wonderful, amazing, fulfilling day!
- AnonymousAugust 17, 2011 at 2:31 PM
Dr. Whoo, I am very sorry that you felt that your specialty was being attacked. Being a physician myself, I never life hearing any doctors attacked.ReplyDelete
I do, however, want to add that much of the explanation that you gave in response to why OB/GYNs are often snappy or downright rude could easily apply to any physician. As an anesthesiologist, I often deal with pregnant women (meaning I also treat two patients at once). I work busy, busy call just as often as the OBs in my hospital and the work I do on call is extremely busy and very high stress. Even on a regular day where I supervise residents, I often do not have time to sit down or eat. I deal with OB nurses and OR nurses who think that they know how I should do my job. I also have children at home with whom I would like to spend more time.
All of that said, I DO NOT treat my residents and clerks the way I was treated by the OB staff when I was a clerk/ PGY-1. I do not snap at my colleagues and I am not unprofessional or disagreeable in the way that many of the OBs that I have worked with are. I have never once witnessed an anesthesiologist exhibit behaviour as deplorable as many of the OBs in the various academic and community hospitals in my city.
I have often wondered what turns lovely people into unkind OBs. Many of my friends are now OBs and I have seen inappropriate behaviour from many of them throughout their training and now practice. Is it the training system? I do not buy your argument that the nature of your work explains away the 'snappish answers, snarky humour' etc. My work is no less stressful and I manage to treat my colleagues and learners with respect, as do my colleagues.
Now clearly not all OBs have frequent moments of bad behaviour, but it seems clear to me (as someone who works with surgeons on a daily basis) that the rate of inappropriate interactions are higher with OBs that with other surgeons or any physician group I know. I think that, as a specialty, this needs to be addressed at both the training level and beyond.
Dr. Whoo - amen to everything. I'm a resident in internal medicine, not ob/gyn, but I think that a lot of what you said resonates across the specialties. We're judged constantly by people with very little understanding of the circumstances under which we work.ReplyDelete
To the anonymous anesthesiologist - do you really think your lifestyle is as bad as that of an ob/gyns? I seriously considered anesthesia in med school and in general the anesthesiologists I talked to seemed to feel that it was somewhat of a controllable lifestyle specialty. No ob/gyn I talked to claimed the same.
All hail the OB/GYN. I'm not a doctor (alternate professional field... the dreaded lawyer) but I appreciate you and your colleagues like mad.ReplyDelete
I'm on my fourth pregnancy. All three of my children were delivered by my OB/GYN, who yes, has a bit of a snarky sense of humor and is a bit pushy, but I LIKE her that way, and I'd never want someone "nicer". She knows her stuff, I don't. She knows when I'm pushing it too hard and will tell me to cut it out, and BECAUSE she's not wishy-washy and nicey-nicey, I listen to her where I wouldn't listen to someone else. She's confident. I need a doctor who tells me what to do, because she knows better than I do. I have enough of my own crap to worry about, I want basic respect and knowledge, and that's what I get. I don't want to "hear all my options for care", I want to trust someone to know what's best for me. She's never come even close to steering me wrong.
Plus, she's a super-amazing person who owns her own practice, has two kids, just bought this gorgeous house, and is sort of a role model for me as a working mom, because what she does is WAY harder than what I do. She's about five years older than me and her kids are about five years older than mine. Plus, I want her wardrobe.
/end of OB-GYN worship for the day.
- AnonymousAugust 17, 2011 at 8:28 PM
Anesthesia in Canada (where I practice) is a busy, stressful, fulfilling specialty. So is OB/GYN. I am baffled by those people who say that Anesthesia is a 'lifestyle specialty'. Those people are universally not Anesthesiologists and have little in the way of understanding of what we do.ReplyDelete
That said, I like my job and I take a great deal of pride in treating my learners and colleagues with respect, no matter how exhausted or overworked I am.
Giz, KC, Dr G, RH +, Melissa, med neophyte, AnonOBwiththeawfulcall, VIPeds, K, OMDG, mom of two doc, Kellie, Cutter, C, anon pediatrician, Lindsey, and Fizzy! (and anyone that I accidentally missed when scrolling) Thank you all for your incredibly supportive comments (and commiseration!) Today was a better day (even helped a patient get a vaginal delivery after prepping for a possible cesarean for stalled induction, yay!) I suffer no delusion that what I describe is unique only to Ob/Gyns, or even only to physicians, for that matter.ReplyDelete
Fizzy, no need to apologize, there were several comments, including Tempeh's above that had a cumulative effect. For my fellow Ob/Gyns in training and in the trenches, keep on keeping on. Most days are good days, and all days are better than residency.
As for the anesthesiologist from Canada, no doubt, anesthesia shares many of the same stresses of Ob. You have a few major advantages, however, 1) Your patients are asleep for the majority of your interactions, and you often may never see them again after they leave the hospital
2) *No office* (no office schedule, staff, overhead, etc.)
3) You are not often the bearer of bad, horrible, devastating news. Over, and over, and over.
4) Wider and more varied patient base, this can be a blessing and a curse.
As for the general attitude, (deplorable? really?) Maybe, because it is a surgical/procedure based specialty, it attracts "no nonsense" surgical-type people. Assertive, confident, when they are men. B*tches, when they are women? I know I have to consciously sweeten my tone often so as not to be perceived as being "angry" (I am not) when I am just being "matter of fact" (or concentrating). This has been addressed on this blog before, as well.
- AnonymousAugust 17, 2011 at 9:59 PM
Dr. Whoo, I sense that your original post was written to elicit sympathy and to justify bad (yes, REALLY, occasionally deplorable) behaviour that OBs tend to engage in more frequently than other physicians (worse, even, than other surgeons, male or female).ReplyDelete
I am sorry that you feel attacked. It is not pleasant to be misunderstood or misrepresented. I do think, however, that it is worthwhile thinking very critically about what you write. Consider whether there is some truth in the original supposition that OBs are overall more bitter and poorly behaved. Why is this so, when your job does not differ substantially in difficult elements to those of many other physicians? Is this fact something that should be addressed or should more excuses be made?
Additionally, it is a reflection of a lack of understanding that you think that the majority of an Anesthesiologist's patient interaction occurs when a patient is asleep. You obviously know how much time we spend with AWAKE women in labour or having C-sections. No doubt you are also familiar with the increasing use of regional anesthetic techniques in various surgeries and acute and chronic pain work that Anesthesiologists do. All of this on AWAKE patients. As well, many of those of us who do pain DO have offices and we follow patients on an ongoing basis. Finally, in Canada at least, many Anesthesiologists also do critical care. As you might imagine, this involves breaking bad news on a regular basis.
Dr. Anesthesia~ Your sense is wrong. I had no wish to garner sympathy in any way. Your supposition and instruction to "think critically" is quite insulting and pedantic (and part of the problem of which I speak). Tempeh asked, some of the other comments stung, as well, I opened up a window and poured my heart onto the page. I can only speak for myself, and can't speak for those you find "deplorable." I was never purposefully personally cruel to a student, nurse, or fellow physician. My attendings in training never treated me poorly. My fellow residents had both good and bad people, much as I suspect many other residencies do. Others (obviously)have had different experiences. I will say that the culture of residency favors constant motion and anticipating 3 steps ahead, not conducive to all med students' learning styles.ReplyDelete
The bitterness (I agree, it exists!) comes with burnout, and with OB, the burnout is high. How could burnout be "addressed?" The demands of the job cannot be changed. Resident hours can't be cut any more than they are, training is marginal as it is. That's what I was trying to convey. Period. I don't know why we are burnt out and anesthesiologists/hospitalists/family physicians are not, because I am not one. I can only posit theories from my own point of view.
If you don't wish me to feel attacked then stop re-directing the original point. Apologies for the incorrect generalizations about your specialty, (ahem). I do not practice in Canada, and *in my area*, anesthesiologists who do pain management do not generally do OR, and those that do OR do not to pain management, few do critical care other than rapid response, nor do *any* of our anesthesiologists sit with any laboring women. They do sit with our C-section patients, and that is a great thing for the women when they can't see beyond the curtain.
Maybe in your area all OB/Gyns are the absolute spawn of Satan and you find it unfathomable that we could be otherwise. I would say if you asked my colleagues, L&D and OR nursing staff, and patients, not a single one of them would say I was inappropriate, mean, rude, snarky (to them), or deplorable. Because I'm not, in a professional setting, I act professionally. As, I'm sure, do you. Perception, however, is reality. It appears that we vary greatly in our perceptions of reality, so let us agree to disagree and bid one another good day.
Interesting post Dr. Whoo. Kudos on your honesty! I really enjoy your perspective!ReplyDelete
As an anesthesia resident, though, I wonder what you mean by "your specialty (ahem)"? I am concerned that you are indicating that you question the validity of anesthesia as a specialty?
- AnonymousAugust 18, 2011 at 11:56 AM
I am neither OB or anesthesia, but have friends in both fields. My observation is OB field is more stressfull for multiple reasons cited by Dr Whoo. People who do primary care tend to have more emotional burn out, surgical specialties have more physical/sleep deprivation burn out. And OB's do both. We have to be grateful for everyone in OB field. They are doing it while many of us cannot. Thank you, Dr Whoo for the work you do.ReplyDelete
JD~ Thank you, and no,that wasn't what I was indicating! Of course anesthesia is a valid specialty! I was apologizing for making incorrect generalizations about the specialty , and virutally clearing my throat (thus indicating I was open to the same ;) ).ReplyDelete
Thank you, Anon 11:56 for articutlating in a more clear way what I was trying to say above. I appreciate your kind words. :)
To the Anesthesiologists,ReplyDelete
I am curious as to your thoughts as to why you feel your profession has less nasty people and more happy ones. Could it be that your overall interaction w/the general public is less than some of the primary care professions? Or for the perceived lifestyle? I know that many colleagues in med school who went into anesthesiology or in residency who chose to leave IM or Peds for anesthesiology did it specifically for the "lifestyle" benefits or for the lack of awake patient interaction.
My experience w/ anesthesologists (for childbirth as well as cancer surgery on my neck as a teen) were not very extensive. I spoke w/ the anesthesiologist for less than 5 minutes each time and for my 2nd child I mostly got grunts in response to my questions (I was told that he was being particularly verbal for me).
I am truly curious as to your thoughts. It seems to me that those professions that have less awake patient interaction have the least amount of burn-out in medicine (i.e. radiology, pathology, anesthesiology, etc).
- AnonymousAugust 18, 2011 at 6:07 PM
It always makes me upset when I see articles and hear stories about how OB/GYNs are so awful/mean/in it for the money/don't know what they are doing. It must be like a slap in the face after all the training and sacrifices they make for their profession. That alone would be enough to make any person "snarky" and unpleasant to be around at times. Which I'm sure is the case for all kinds of specialities (my husband, a orthopedic PA included :) ).ReplyDelete
I'm just a soon-to-be nursing student but have been through a lot with my OB/GYN and can respect everything she has on her plate. She's taken the time out of her schedule to just sit and cry with me through my 4 miscarriages. She's taken the time out of her day to call me directly and answer any of my questions. She's taken the time out of her day to schedule an evening ultrasound just so she is the one to do it and not a tech. During all this she is getting behind, probably missing lunch and dinner with her family and many more things.
I will always have the utmost respect and admiration for our OBs. Many people acknowledge how easy and happy their patients must be but there is a different side to their job that they handle with grace, kindness and strength and I'm sure it is not without a price...
Thanks for being you Dr. Whoo! Although, not everyone acknowledges what you do, there are some that will always remember what you've done for them.
As a fellow ob/gyn, I wholeheartedly agree with dr. whoo's comments on reasons for why those in our profession might appear "bitter". However, given the forum, contextually I interpret this to mean how we appear to our non ob physician colleagues, rather than being a comment on our professionalism. I can neither refute nor validate the opinions previously voiced by the Canadian anesthesiologist, but I don't think in the US it is generalizable that ob/gyns are seen as rude, unpleasant and unprofessional to their physician, nurse, PA, NP, or CNM colleagues, support staff and patients. I am sorry she has had that experience, but I don't think a mature individual, physician or other profession, would behave inappropriately or unprofessionally and expect any eloquence to excuse it. I think it is a misapprehension to think that discussing this topic of "bitterness among ob/gyns" was ever meant to excuse reprehensible behavior. An attitude of "bitterness" has the connotation of more expressed frustration and less satisfaction with the outcome of our choice of specialty rather than to a lack of regard for humanity (although God knows we get impatient with some members of His creation at times!) That said, although I struggle to have it all work out with marriage, 3 kids and a demanding profession I follow the Golden rule in my interactions and take full responsibility for same. And unless stated otherwise, I would have no reason to assume any less from the contributors to this blog/forum.ReplyDelete
- AnonymousAugust 19, 2011 at 3:21 AM
I would agree entirely with the previous poster's comment. For your call week and schedule, you make a good money as well. and you should take responsibility for your career choice and not take out frustration on people who pay to see you,ReplyDelete
I am a s\w engg who has forgone a hefty salary in downtown chicago for a job near the suburbs offering flexibility so i can spend more time with my family
i had student loans, work experience still i choose to make 70k when i can make upwards of 110k instead of making 110k and being bitter and rude
- AnonymousAugust 19, 2011 at 10:12 AM
Anon above - OBGYN do not have choice of making less and not "being bitter and rude" - OB is all or none type of job.ReplyDelete
- AnonymousAugust 19, 2011 at 10:59 AM
I am an older pre-med and have been interested in ob/gyn based on the caliber of the doctors I've seen. My ob and gyn doctors have taken the most thorough histories and given me the best primary care of any doctor I've seen. This forum (don't worry - not this particular thread) has me wondering if ob/gyn is really right for me because I am not as interested in surgery as primary care. But learning more about what ob/gyn training involves leaves me even more awed by the wonderful doctors I've had over the years. It sounds like a few bad apples are fouling up the place - but the majority of you guys (guys and gals alike) are heroes AND good, patient, caring doctors.ReplyDelete
Yikes! Looks like I let the genie out of the bottle and then left the premises. Dr. Whoo, totally sorry if my comments were offensive. As I'm seeing from your post (which was really eye-opening) and many of the comments from others, I had a very neatly packaged view of Ob/Gyn...a little medicine, a little surgery, healthy patients, new pink babies...what's not to love? I guess all of the other issues, most notably the concerns about malpractice and the unpredictability, are largely things I've had no reason to witness. Anyway, to echo what others have said, I have a lot of respect for what you do. I have 3 healthy kids that were brought safely into this world by 3 different obstetricians, and that means the world to me. Thanks for sharing and hope it was at least a little therapeutic to purge what sounds like a very tough day.ReplyDelete
- AnonymousAugust 21, 2011 at 4:11 PM
As a non-OB/GYN resident, I understand and appreciate the stress, hard-work, and under appreciation of those that work in the field. I briefly considered a career in OB/GYN, but was dissuaded by multiple people in the field during my med school rotation. I thought it foolish to disregard their advice, and ultimately, I'm glad I kept looking because I work in another area that blends medicine and surgery that I love. But when residents and fellows tell you *unsolicited* that they are unhappy with their career choice, and even attendings say they would have picked another field of medicine knowing what they know now, it leaves an impression. The system is broken, and it grinds on those willing to put themselves in the line of fire. I hope there is an increasing trend towards laborists (like hospitalists), better work hours, and improvements in the litigation system so that OB/GYN gains more attraction for future MDs (and improves the lives of already existing docs).ReplyDelete
- AnonymousAugust 22, 2011 at 4:54 AM
Anon @ 3:21 –ReplyDelete
It sounds like you may have experienced somebody, whom you have paid to see, taking out their frustration upon you. Please know that nobody here is excusing such a thing.
Your comments illustrate the very reason why this blog was created. It isn't a fault that neither you nor anyone else outside of this strange subculture cannot truly understand our experience. It's just a fact. There are physical therapists, engineers, PhDs, nurses, CRNAs, attorneys, teachers and countless other professionals who have abandoned their first careers and sought a second in medicine. Ask any one of them and they will gladly tell you how impossible it is to compare the course of medical education and subsequent career with any other profession. They will likely say they thought they knew what they were "getting into" only to find they had no idea! That isn't a "we work hard and nobody else does" comment, just one of fact. The insistent weight of day-to-day being responsible for the safety and well-being of others' lives, the unavoidable and inescapable exhaustion, the demoralizing and spirit-trampling training, the relentless second-guessing of one's self, the burden of student loans far and above those required for an engineering degree, the finances required to move into practice when already buried in debt at the end of residency - these things cannot be compared apples-to-apples with the life you've chosen.
As the previous poster noted, Ob-Gyns (as well as most other physicians) do not have the luxury of choosing a suburban office, fewer hours and less money to trade off for enjoying flexibility and family time. If it were a simple 40,000/year pay cut to gain those things of which you speak, it would doubtless be an easy choice for most. That just isn't an option. The taking-of-responsibility of which you mentioned precludes such a thing. Beyond that, nobody (in their right mind) would choose Ob-Gyn for the money. There are many more painless ways of earning a living. For the majority of us, we chose this path because we care deeply and feel something akin to this being our "calling". So while it is nice to make a good living (and begin digging out from under the mountain of debt), the money wasn't the motivation for doing the job in the first place and so it also isn't the reward which you and many others assume. It is a by-product. Part of that taking responsibility means giving up the freedom of leaving "the office" and not having to worry about it until walking back in, it means working the longer hours to see those last two patients that needed to be worked in even though it means missing your kid's ball game when you either don't need the money or will actually be losing money to see them. That last part may sound absurd but I assure you that there are times when seeing a patient literally means taking a financial loss.
This is simply a forum for those of us experiencing this path to share the difficulties, triumphs, experiences and realities with one another. Those of us frequenting this forum are coming here to better ourselves through taking lessons and/or solace and relief from the stories and camaraderie of our peers. We know we are fortunate to have medicine as our career. We value our patients. But we are also human. So we do take responsibility for our career choice and that is why we work very hard to not let our exhaustion and burn-out bleed through to be seen and/or experienced by others, especially those whom we've dedicated ourselves to providing healthcare. But the human condition does not except physicians and it was that to which Dr. Whoo was speaking. It was at the behest of a commenter and not offered as an excuse but as an explanation.
The post and comments offer some fascinating thoughts. I was interested in what Marce said, and although I considered myself in the healthy, realistic 30% she would likely peg me in the crazy doula set simply because I had a doula and birth plan (and did just fine with no drugs.)ReplyDelete
Here's the thing, though, for most labors in my area the OB is not really as relevant as the nurse. This is our health care system in action. My labor was fine, the OB showed up at the end and stayed calm when the nurse wanted to send me off to the OR. A friend told the nurse over and over she needed to push, was blown off by said nurse until the anesthesiologist came in and said "you idiot, she's complete", and had a blue baby who didn't move one half of his body until 6 months old.
I only know of two "bitter" OB/GYNs online -one being OB/GYN Kenobi and the other a man. IRL, there is only one bitter OB that comes to mind. He constantly posts on facebook about having to stay over for another delivery or has to work in the clinic. He loves surgery. Too bad he can't just to robot hysts all the time.ReplyDelete
Everyone else seems well adjusted and happy. One has been doing it for 30+ years. That was my n=1 example. Hopefully, I won't turn into a bigger misanthrope (misogynist would probably be better fitting) by the time I'm on OB.
- AnonymousSeptember 1, 2011 at 5:49 AM
OB/GYNs have the option of working part-time. That's very common in my area.ReplyDelete
Doesn't matter to me as a patient, as IME they're inadequate primary care physicians. After a truly terrible (non-birth) experience I'll never see one again unless I'm on my deathbed with a GYN problem. Even then, I'd request a general surgeon, if possible. Yes, it was a group of female OB/GYNs with which I had the poor series of experiences. It wasn't possible to see how burned out and bitter my physician was until she royally screwed up and tried to cover her tracks by blaming me.
I am sure that OB-GYN's have to put up with a lot of stress, but then all of us in medicine do. I had a horrible experience rotating through OB-GYN. I happened to be pregnant at the time. I had awful nausea and vomiting during the rotation. I often had to go puke in between seeing patients. It is difficult to have time to go eat sometimes. As a result, I began to lose a significant amount of weight. My actual OB-GYN who was treating me told me that I needed to watch my weight or it would adversely affect my pregnancy. I tried to eat more. The female residents on the rotation, ganged up on me one day and told me that I was eating too much. They did not know that I was puking in the bathroom or that my OB told me I needed to watch my weight. They definitely made me feel like the unpopular girl being ostracized by the popular girls. It's ironic that the very profession who should be sensitive to needs of pregnant women were mocking me.ReplyDelete


text:
TNB: Project FAIL
Anderew Bisharat struggles on his long time climbing project at Rifle, Colorado.
I entered Canyon Land with the uncomfortable wish that today would be different. I feel an eerie sense of
trepidation about change, especially when it concerns my most reliable routine: falling on my project. Ironically, it's never clear why we ask for
change in the first place, or what will become of us in the end; we only know that we want things to be different because different sometimes means
better. Unfortunately, it would be easier for me to change autumn into summer than to cease falling on my most longstanding project ever.
Semantics can be important in climbing. You must not call a flash an onsight—a disturbing trend among today's youth. It's no longer apropos to say
"project" when referring to this particular route, a cruel dominatrix called Living in Fear in the darker recesses of the Rifle Mountain Park
canyon. The word practice somehow makes more sense. Projects inherently come to an end, but you can practice something for the rest of your
In Canyon Land, as Rifle is sometimes called, the inevitable question arises. "What are you working on?" People want to know this specifically. No one
asks or cares about what successes you've had, if you were lucky enough to have any. What are you trying to do? They could cut to the chase
and simply ask, "In what ways have you suffered today?" This paradoxical response, the enjoyment we derive from watching someone else's pain, defines
the unique culture of Rifle. It's a scene here, with cliques and drama and a bunch of other high-school-grade bullshit. Understandably, many will be
turned off by it. But those who stay here eventually find comfort in each others' failures. I know of a few popular routes with guaranteed fall points,
and anytime I am truly desperate, I will park a folding chair beneath these climbs and sit until I feel better. The greatest pleasure humans have ever
known is not comedy, but tragedy.
I've been trying Living in Fear for so long that the members of this queer outdoor gym have recently convinced themselves that I've already redpointed
it—an interesting twist. The idea that anyone could try one route for so long without success is too terrible for most to comprehend. I now get
this reaction: "Oh, I thought you did that already." I find this to be a pinprick, both in the present as well as to that future moment when, if, I
actually send.
People think sport climbing is an exercise in foregone conclusions, and in some ways, they're right. Enslave yourself to one climb long enough and eventually
you should be able to get 'er done. The infinite monkey theorem comes to mind. Put monkeys in a room, give them MacBooks, spank 'em on the bottoms
to set them typing and, some time near infinity, they'll produce Shakespeare. The monkeys have it easy, I think. We only get six weeks between issues
here at Rock and Ice. But success isn't always guaranteed, no matter how long you try, and in this regard sport climbing gets less credit
than it deserves.
I remember watching Will Gadd at the 2010 Ouray Ice Fest top-rope the same bleak waterfall for 24 hours straight. Gadd's half-cocked idea was to raise
money and awareness for the dZi Foundation, which builds programs to improve education and quality of life in small villages in the Himalaya. Around
hour 20, and lap number 170 (of a total 194), I checked back in on Gadd. His footwork had gone to shit and he was slobbering like a fool, his saliva
now neon green from pigging out on his favorite energy drink, which shall not be named. A gang of adoring savages stood around, cheering him on and
holding signs that read, "God is now spelled Gadd!"
"Poor devil," I thought. Being doomed to climb a single route for an eternity is precisely my version of hell.
My hell, however, gets spread out, which certainly makes it more bearable. I've found it takes five full days for the pain of last weekend's failure to
subside, and for Hope to regenerate. Thankfully I have a full-time job that aids in keeping me off the rocks, and away from the precipice of that unique
insanity some endure when climbing is all they have in life.
It occurred to me that, though I have other stuff to do beyond climbing, my life is basically one giant exercise in making lists and ticking checkboxes.
I sometimes feel as though ticking something off—whether it's finishing a column, making a car payment or occasionally sending a route—is
the greatest pleasure I can expect on any given day. Perhaps this is why sport climbing is so popular … or perhaps why it isn't. Does the trad/sport
divide come down to the mundane peculiarity of whether a person likes ticking boxes?
I normally wouldn't be so public with the details of my project, I mean, practice, because I have the good sense to know better. In the climbing world,
being specific about what you're doing is sharply offensive. No one likes spray as a general rule. None of us seem capable of valuing any ascent other
than our own without cloaking our most atavistic sentiments in the superficial exclamations and encouragements of a Hollywood housewife. (A few rare
individuals are exceptions to this rule, and I cherish them like precious single malts.)
If anything, mentioning the source of my greatest act of foundering is embarrassing since this route is, without exaggeration, a warm-up for many. In theory
I'm happy that the projects of yesterday are now the warm-ups of today, for this is how it should be. Still, a lineage of climbers has been dimmed
and ultimately vanquished by Living in Fear. Occasionally I see one of these defeated Gollum-creatures, with their sad vestigial forearms,
off to go kayaking, biking or any other equally vapid activity with a high success rate. Say Living in Fear to them, and they shrink, hiss
and scamper into the shadows.
Living in Fear is relentless, despite being a mere 70 feet. The beta, for everyone regardless of stature, is exactly the same—a despicable
though interesting repercussion of the route's chipped nature. There's only one place, perfectly halfway up, to match hands, and this is Living's lone "rest," a term used ironically, of course. The longer you try to shake on this angled bathtub-slick sloper known as the Bevel, the more tired
you become.
Above the Bevel, harder climbing leads to the most devious fall point, the 5.8 Dyno, another sinister, ironic term. Here you grab the route's best, most
incut hold and pull hard to reach its second-best incut hold. It's a horrible, unaccountable anomaly, on par with the rise of the Tea Party, that people
fall here. If you have a thin right-hand pinky, you can finagle a crummy knuckle jam in a chiseled-out slot and shake out before the 5.8 Dyno—a
massive advantage this high on the route. If your finger, like mine, doesn't fit, you're doomed to climb through the searing pump.
Above the 5.8 Dyno is the Death Dihedral, and though no one has ever died here, the misery of deciphering this cryptic, crimpy sequence has caused some
(including me) to puke in their mouths. The only other time exercise has caused regurgitation was on the Charles River in Boston, where I rowed crew
for a stint. The unremitting action of rowing a boat while being shouted at by a tiny, very ugly female coxswain, feels nearly identical to being on
redpoint on Living, except here, instead of one coxswain, you have a dozen equally scaled-down people on the ground yelling up.
Living in Fear got its name because the first ascentionist, Scott Frye, was rumored to have been afraid that someone was going to walk up to his
work of art and onsight it before he could do the first ascent. "It's just not that hard," he fretted during his long redpoint battle. And in some
ways, it's not. No move is harder than V5, but not a single one of its 49 moves is easier than V3, and somehow this equates to a rating of 5.13d.
For reference, taking into account inflation, climbing Living in Fear today is roughly equivalent to climbing 5.8 in the 1950s, 5.9 in the '60s,
5.10 in the '70s or 5.11 in the '80s. In other words, nothing worth sending in to Hot Flashes—though what is? Grades are mere variables in the
algebraic equation of the climbing experience, not crucial to its ultimate worth or meaning. I find it crazy that people take grades so seriously—like
the fisherman who only cares about the size of his fish and is blind to the beauty of the river he's standing in. In every worthwhile experience are
core values that do not change, even over time, no matter what the numbers suggest.
To take my mind off the anxiety and dread I feel toward this route, I sometimes join the other Lilliputian climbers in making their particular perambulations
up and down the road splitting the park. We stare at the canyon walls and from a distance do our best to dissect their peculiar anatomies for sequences
and clues to their outstandingly physical enigmas. It reminds me of the experience of being a kid, looking at maps. The colors, place names and distinct
borderlines tend to craze children, and even to this day I find maps magnetic. The first thing I do upon boarding a plane is flip to the back of the
in-flight rag and stare at the map, tracing the lines toward all the beguiling places I could go, etching these details into my mind.
Beyond its Gothic architecture, Canyon Land has many distractions and, depending on what mood I'm in, these things either alleviate my self-pity or they
bother the shit out of me. Much of Canyon Land has undergone a facelift, with many new routes and lots of route maintenance being done. The number
of 5.14a's here has doubled this season. It's shocking how much drama can arise out of the placement of a single bolt, even among a group of like-minded
individuals. Design By Committee really doesn't work when it comes to establishing climbs, retro-bolting them or determining whether they are "worthy"
of having fixed draws. My opinion on all matters related to establishing routes is simple: those who don't put up routes don't get to have an opinion.
All life is lived between the lines. There is no single answer for how routes should be put up—or even that they should. This is only disheartening
if you're a stickler and don't understand that climbing should never be taken seriously. Despite my whining about not sending, in my day-to-day reality,
I remain committed to treating climbing with full irreverence, manifested in my savage gluttony for good food and beer, shared with close friends,
preferably to loud music.
My friend Sam Elias put up an extension to Living in Fear, which of course adds more difficulty. After bolting the extension, he went away for
a week only to come back and find his vision co-opted by a couple of other climbers, who had ticked up the route, found new holds and sent the extension
before Sam had even had a chance to try it. But Sam took the second ascent graciously.
For me, the new route ignited some ignoble feelings, which caught me off guard like a loud fart in front of your date. At first, my ego reeled at the new
extension's sudden appearance because it trivialized my ongoing efforts. It took a little bit of reflection and foresight not to be discouraged by
the appearance of Living the Dream and instead find it ultimately motivating. I now look at it as a riveting checkbox, standing on deck.
One trend I've noticed in Rifle, and probably sport climbing in general, is that people tend to play to their strengths, choosing routes that suit them.
What's more important? Redpointing or becoming a better climber? The two are not always one and the same. Canyon Land's beloved philosopher Maurice
Waugh first presented me with this koan and discouraged me, via insults, from using certain resting kneebars on very particular routes in favor of
just climbing straight on. It took longer to send, but ultimately paid off.
Still, I wonder why I feel such anxiety over sending a route like Living in Fear, which is my complete anti-style. It's especially confusing
since I know that, as soon as I do send, I'll only replace this challenging experience with another one. It's the classic Zen question of what is more
important: to climb 100 mountains or climb one mountain 100 times.
On my latest attempt on Living, I found some subtle new beta. It's a small difference, a soft tweak in body position, but I think next weekend
things are going to change.
Andrew Bisharat counts the years by the number of Sendtembers and Octobers that pass by.


text:
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